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Application Process Under this process individuals have the option to supply the NICS Section with information such as name date of birth social security number and any other identifying numbers using the VAF application included in this brochure to request entry into the file. VOLUNTARY APPEAL FILE VAF APPLICATION Date of application U.S. Department of Justice Federal Bureau of Investigation Criminal Justice Information Services Division Please fill out the following information Denotes Mandatory Information THIS APPLICATION MUST BE ACCOMPANIED WITH A COMPLETED FINGERPRINT CARD NOTE If you are interested in applying for the VAF please ensure you read and sign the Applicant s Statement on the reverse side of this application. An application cannot be processed without an original signature. APPLICANT S STATEMENT I give the information on my VAF application voluntarily with the understanding that if my application is successful I will be entered into the FBI Criminal Justice Information Services Division s National Instant Criminal Background Check System NICS Section. I understand if at any time I wish to be removed from the VAF I can make a request in writing to the NICS Section to be removed. I also understand if the NICS Section into the VAF the NICS Section may remove my SIGNATURE DATE A signature is required on the above applicant s statement. Documents that may clarify records or prove identity e.g. fingerprint cards court records pardons etc. will be entered in the VAF along with the descriptive information from the application. This application a set of rolled fingerprints and any supporting documentation should be sent to the following address Post Office Box 4278 Clarksburg WV 26302-4278 After reviewing the application and fingerprint card and validating the materials submitted by the applicant the NICS Section will enter successful applicants into the VAF. The applicant will be notified by mail if their application qualifies for entry into the VAF. Entry into the VAF will not automatically result in a proceed response on subsequent purchases. Last Name First Name Social Security Number Date of Birth Day Year Month Middle Name State of Residence Place of Birth State Gender Race 1 American Indian or Alaskan Native 2 Hispanic or Latino 3 Black or African American 4 Asian 5 Native Hawaiian or Other Pacific Islander 6 White or Caucasian 7 Unknown Female Weight Eyes Hair MAILING ADDRESS for receiving correspondence OTHER LEGAL NAMES Last Name Cadence Telephone Number Male OMB No 1110-0043 Country of Citizenship REASON FOR APPLICATION Alien Registration Number mandatory if Miscellaneous Numbers Military ID Driver s License Additionally if you have denied transactions you would like for the NICS Section to place under appeal along with your VAF application you must provide the NICS Transaction Number s. NTN s NOTE THIS IS NOT AN APPEAL BROCHURE. HOWEVER THIS APPLICATION CAN BE USED TO INITIATE AN APPEAL ALONG WITH APPLYING FOR THE VAF. IF YOU WANT TO INITIATE AN APPEAL PLEASE PROVIDE THE NICS TRANSACTION NUMBER ON THE BOTTOM OF THIS APPLICATION. FOR MORE VAF INFORMATION Customer Service 1-877-FBI-NICS 324-6427 Telecommunications Device for the Deaf TDD 1-877-NICS-TTY 6427-889 Brady Act Requirements The Brady Handgun Violence Prevention Act of 1993 Brady Act Public Law 103-159 was signed into law in November 1993 requiring Federal Firearms Licensees FFLs to request background checks on individuals attempting to purchase a firearm. The permanent provisions of the Brady Act which went into effect on November 30 1998 required the U.S. Attorney General to establish the National Instant Criminal Background Check System NICS that any FFL may contact by telephone or by other electronic means for information to be suppilied immediately on whether receipt of a firearm by a prospective transferee would violate Section 922 g or n of Title 18 United States Code or state law. The FBI developed the NICS through a cooperative effort with the Bureau of Alcohol Tobacco Firearms and Explosives ATF and local and state law enforcement agencies.

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